Nap polysomnography in infants with laryngomalacia as a tool to predict treatment strategy.

Autor: Lajili M; Service de Physiologie Pédiatrique-Centre du Sommeil, AP-HP, Hôpital Robert Debré, 75019, Paris, France., Teissier N; Service d'Oto-Rhino-Laryngologie, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 75019, Paris, France., Dudoignon B; Service de Physiologie Pédiatrique-Centre du Sommeil, INSERM NeuroDiderot, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 48, Boulevard Sérurier, 75019, Paris, France., Benoit C; Service d'Oto-Rhino-Laryngologie, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 75019, Paris, France., Bellanger S; Service d'Oto-Rhino-Laryngologie, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 75019, Paris, France., Kahn L; Service d'Oto-Rhino-Laryngologie, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 75019, Paris, France., Van Den Abbeele T; Service d'Oto-Rhino-Laryngologie, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 75019, Paris, France., Delclaux C; Service de Physiologie Pédiatrique-Centre du Sommeil, INSERM NeuroDiderot, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 48, Boulevard Sérurier, 75019, Paris, France., Bokov P; Service de Physiologie Pédiatrique-Centre du Sommeil, INSERM NeuroDiderot, AP-HP, Hôpital Robert Debré, Université de Paris-Cité, 48, Boulevard Sérurier, 75019, Paris, France. plamen.bokov@aphp.fr.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Jun; Vol. 281 (6), pp. 3107-3113. Date of Electronic Publication: 2024 Apr 04.
DOI: 10.1007/s00405-024-08623-y
Abstrakt: Purpose: This study aimed to investigate the role of nap polysomnography (NPSG) in predicting treatment strategies for infants with moderate to severe laryngomalacia and to explore the association between obstructive sleep apnea (OSA) severity, weight gain, and laryngomalacia severity.
Methods: A retrospective analysis was conducted on infants diagnosed with moderate to severe laryngomalacia who underwent NPSG between January 2019 and June 2023. Clinical variables, NPSG parameters, and treatment decisions were collected. Weight gain rate and its correlation with NPSG indices were assessed. Logistic regression analyses were performed to predict treatment strategies based on NPSG findings.
Results: Of the 39 infants included (median age: 3.3 months), 77% exhibited OSA, with 69% having moderate to severe OSA [apnea-hypopnea index (AHI) > 5/h]. Weight gain rate correlated negatively with indices of OSA severity, including the hypopnea index (HI) and the AHI. In a multiple logistic regression analysis incorporating the severity of OSA (AHI), weight gain rate, and laryngomalacia severity, only AHI predicted the decision for surgical or non-invasive ventilation treatment (OR = 2.1, CI 95 [1.6; 2.8], p ≤ 10 -4 ). The weight gain rate was predicted (r 2  = 0.28) by the AHI and the presence of retractions of auxiliary inspiratory muscles.
Conclusion: This study underscores the importance of NPSG in assessing infants with moderate to severe laryngomalacia. The AHI from NPSG emerged as a potential predictor for treatment decisions and weight gain rate, emphasizing its clinical relevance. These findings advocate incorporating NPSG into the diagnostic and management process for infants with laryngomalacia.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: